Writing Up the Physical Examination

Listed here are examples of the write-up for the examination of the male genitalia.

• The penis is circumcised. Both testes are in the scrotum and are within normal limits. There are no abnormal scrotal masses. No inguinal hernias are present. No inguinal adenopathy is present.

• The penis is uncircumcised. The foreskin is easily retracted. The left hemi-scrotum is markedly enlarged by a painless mass that can be transillumi-nated. The left testicle cannot be palpated. The right testicle is within normal limits. No inguinal hernias are present. A small, 2 x 2 cm [0.75 x 0.75 inch], soft, nonfixed, nontender lymph node is present in the right inguinal area.

• The penis is circumcised. There is a 1- to 2-cm [0.40- to 0.75-inch] verrucous mass at the external meatus. A thick, yellow, purulent urethral discharge, which can be milked from the urethra, is seen at the meatus. The scrotal contents are within normal limits. No inguinal hernias are present.

• The penis is uncircumcised. The foreskin is tight, although it can be retracted by the patient. A large amount of smegma is present behind the corona.

There is a large mass of nontender, dilated veins present in the left hemiscrotum that can be seen and felt when the patient stands. An impulse is felt in the left spermatic cord upon coughing. No inguinal hernias are present.

• The penis is circumcised. The left testicle is soft and measures 2x3 cm [0.75 x 1.20 inch]. The right testicle appears normal. The scrotal contents are within normal limits. The hernia examination on the left side reveals a prominent impulse when the patient coughs. This impulse is felt at the tip of the examiner's finger.

• The penis is circumcised. There is a 1-cm [0.4-inch] painless ulcer with a clean, nonpurulent base at the corona. The ulcer is indurated and has a smooth, regular, sharply defined border. Painless, firm, movable inguinal lymphadenopathy is present bilaterally. The testes are normal, as are the other scrotal contents. No inguinal hernias are present.

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